Basic Information
Provider Information | |||||||||
NPI: | 1912205667 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | TEXAS HEALTH PHYSICIANS GROUP | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | ORTHOPEDIC SURGERY SPECIALISTS | ||||||||
OtherOrganizationType: | 3 | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2900 N I-35 | ||||||||
Address2: | STE 200 | ||||||||
City: | DENTON | ||||||||
State: | TX | ||||||||
PostalCode: | 762015141 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9403233400 | ||||||||
FaxNumber: | 9403233410 | ||||||||
Practice Location | |||||||||
Address1: | 2900 N I-35 | ||||||||
Address2: | STE 200 | ||||||||
City: | DENTON | ||||||||
State: | TX | ||||||||
PostalCode: | 762015141 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9403233400 | ||||||||
FaxNumber: | 9403233410 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/04/2011 | ||||||||
LastUpdateDate: | 11/18/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | PARSLEY | ||||||||
AuthorizedOfficialFirstName: | SHAWN | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
AuthorizedOfficialTelephone: | 2148606300 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: | DO | ||||||||
NPICertificationDate: | 11/18/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X |   |   | Y |   | Suppliers | Durable Medical Equipment & Medical Supplies |   |
No ID Information.